11/12/20: I have Lyme Disease!!!!!

OMFG!!!!!

Can I not catch a medical break?!?

I know this is supposed to be a cancer blog, but I figured I'd make this post anyway, since I already mentioned the tick bite. 

So here's what happened, with pictures. 

The tick bite was on my waist. According to this very informative web site that dispels myths about Lyme Disease, "Ticks don’t jump, fly, or drop from trees. They crawl up." The tick probably climbed up the outside of my pant leg until it found some flesh to bite. Ugh. Gross! This is why you're supposed to tuck your shirt into your pants, if you want to prevent tick bites. 

This is what the bite looked like after the tick was removed:

The area just around the bite stayed a bit red, and the bite itself scabbed over. After a couple days it settled down to look like this, and stayed that way for about 2 weeks:

I figured, once the scab falls off, I'll be out of the woods. But no! After 17 days, I saw this:

An early symptom of Lyme Disease is a rash that appears between 3 and 30 days at the site of the tick bite. The CDC says the rash "may feel warm to the touch but is rarely itchy or painful"; mine is definitely warm to the touch and also definitely itchy. The rash gradually expands, and sure enough, 2 days later (today), it looked bigger:

But where's the bullseye?! The same myth-busting web site linked above says that less than 50% of cases involve a bullseye-shaped rash. In fact, according to the CDC, 20-30% of cases don't even have a rash at all. I guess I should be thankful that I did develop a rash; if my Lyme Disease symptoms started with a fever, I would have been worried about COVID-19 first, which would have delayed my Lyme Disease diagnosis for sure. If it started with fatigue and joint aches, I'd have chalked it up to my daily dose of exemestane, and who knows how long it would have taken to diagnose Lyme Disease!

Anyway. So today, 19 days after my tick bite, I called the doctor. My regular PCP wasn't available, so I saw another doctor in the same practice. I liked him; he was very calm and patiently answered all my questions. I told him the whole story, then he took one look at the rash and said, "I think we should treat you for Lyme Disease." He said it's possible I could have some other tick-borne disease, but the treatment would be the same, the antibiotic doxycycline.  

I said maybe it's not Lyme Disease, because as far as I could tell, the tick was probably attached for less than 36 hours, and some web sites say that Lyme Disease is "unlikely" unless the tick is attached for at least 36 hours. He said there's always a chance of transmission, it's just more likely the longer the tick is attached. Back at home, I found this web site that confirmed, "The risk may be low the first day, but it’s not zero... The longer a tick stays on you, the more likely it will transmit disease."

I asked if I should get tested for Lyme Disease, and he said it's not necessary because the rash is clearly related to a tick bite, and he would prescribe the same antiobitic no matter what the specific diagnosis is. He said testing is usually used when a patient has symptoms but no known tick bite, to figure out what's wrong.

He gave me a 10-day antibiotic prescription. The rash should go away, and no follow-up is needed. I should call again only if the rash doesn't go away, or if any symptoms persist after 10 days.

I've heard of people having chronic Lyme Disease symptoms, so I asked if Lyme Disease is curable? His answer was in line with what I later confirmed on the CDC FAQ: "Although most cases of Lyme disease can be cured with a 2- to 4-week course of oral antibiotics, patients can sometimes have symptoms of pain, fatigue, or difficulty thinking that last for more than 6 months after they finish treatment." I guess I will just cross my fingers that I fall under "most cases". 

10/30/20: Lupron

Got my monthly shot. Nothing too exciting there.

The steri-strips over my port removal incision still haven't come off. It's been almost a month. The discharge papers say the strips will fall off on their own, but don't say how long it should take. Google tells me they usually fall off in about 2 weeks, but my nurse today said it's okay if they take 4-6 weeks. She suggested I could help them along a little by gently washing the area with a washcloth in the shower. I'll do that; so far I've just been letting soapy water run over them.

I also decided to show the nurse the tick bite I got last Saturday. I walk in the area behind my house, and there's a short path through some light woods. I was wearing long sleeves and long pants (though the top wasn't tucked in), and I certainly didn't rub up against any branches or leaves. So this means a tick somehow fell on me, and crawled on my clothes and body until it found a spot on my waist to bite. Ugh! Gross. I'm not even sure if the tick bit me on Friday or Saturday, but I found it on Saturday. Ken pulled it out with tweezers. There was a tiny hole where the tick was, a small dark purple dot around the hole, and then a larger red patch around that. I've taken pictures of it almost every day since, and it looks like it's getting better, but I figured I'd show the nurse just in case. I showed her the photos and she agreed it looks like it's improving. She said to watch out for fever, chills, warmth in the area, and a growing rash. If I get any symptoms, I should contact my PCP.